Table Of ContentTherapeutic Approaches in Work with
Traumatized Children and Young People
http://avaxhome.ws/blogs/ChrisRedfield
Community, Culture and Change
(formerly Therapeutic Communities)
Series editors: Rex Haigh and Jan Lees
Community,CultureandChangeencompassesawiderangeofideasandtheo-
reticalmodels relatedtocommunitiesand culturesasawhole,embracingkey
TherapeuticCommunityconceptssuchascollectiveresponsibility,citizenship
andempowerment,aswellasmultipisciplinarywaysofworkingandthesocial
origins of distress. The ways in which our social and therapeutic worlds are
changing is illustratedby theinnovativeand creativework described in these
books.
Therapeutic Communities for Children and Young People
EditedbyAdrianWard,KajetanKasinski,JanePooley,AlanWorthington
TherapeuticCommunities10
ISBN1843100967
The Time of the Therapeutic Communities
People,PlacesandEvents
LiamClarke
TherapeuticCommunities12
ISBN1843101289
Therapeutic Communities
Past,PresentandFuture
EditedbyPenelopeCamplingandRexHaigh
ForewordbyJohnCox
TherapeuticCommunities2
ISBN185302614X
Introduction to Therapeutic Communities
DavidKennard
TherapeuticCommunities1
ISBN1853026034
Therapeutic Approaches
in Work with Traumatized
Children and Young People
Theory and Practice
Patrick Tomlinson
Foreword by Paul van Heeswyk
Community, Culture and Change 14
Jessica Kingley Publishers
London and Philadelphia
All rights reserved. No part ofthis publication may be reproduced in any material form
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ofthe copyright owner except in accordance with the provisions ofthe Copyright, Designs and
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written permission to reproduce any part ofthis publication should be addressed to the publisher.
Warning: The doing ofan unauthorised act in relation to a copyright work may result in both a
civil claim for damages and criminal prosecution.
The right ofPatrick Tomlinson to be identified as author ofthis work has been asserted by him
in accordance with the Copyright, Designs and Patents Act 1988.
First published in 2004
by Jessica Kingsley Publishers
116 Pentonville Road
London N1 9JB, UK
and
400 Market Street, Suite 400
Philadelphia, PA 19106, USA
www.jkp.com
Copyright © Patrick Tomlinson 2004
Foreword copyright © Paul van Heeswyk 2004
Second impression 2005
Library ofCongress Cataloging in Publication Data
Tomlinson,Patrick,1962-
Therapeuticapproachesinworkwithtraumatizedchildrenandyoungpeople:theoryand
practice/PatrickTomlinson;PrefacebyPaulVanHeeswyk.--1stAmericanpbk.ed.
p.cm.-- (Therapeuticcommunities;14)
Includesbibliographicalreferencesandindex.
ISBN1-84310-187-4(pbk.)
1. Psychictraumainchildren--Treatment. I.Title.II.Series.
RJ506.P66T652004
618.92'8521--dc22
2003026800
British Library Cataloguing in Publication Data
A CIP catalogue record for this book is available from the British Library
ISBN-13: 978 1 84310 187 1
ISBN-10: 1 84310 187 4
ISBN pdfeBook: 1 84642 073 3
Printed and Bound in Great Britain by
Athenaeum Press, Gateshead, Tyne and Wear
Contents
foreword 11
PaulvanHeeswyk,Associationof ChildPsychotherapists
acknowledgements 14
Introduction 15
Emotionalunintegrationandintegration 18
Emotionalcontainment 19
1. The Cotswold Community 22
Thetherapeuticresourcerole 23
Thetherapeuticresourcemeeting 24
2. Primary Provision – Theory And Practice 26
Adaptationtoneed(theprovisionof‘specialthings’) 26
Workingwithomnipotentbehavior 30
Emotionalpreoccupationandtheprovisionwemakeforchildren 31
Transitionalobjectsandtheuseof teddybears 33
Thetherapeutictaskwithemotionallyunintegratedchildren 34
Theroleoffocal-carerandback-upcarer 37
Theimportanceoffoodinatherapeuticsetting 39
Mealtimes 40
Foodandchildren’sphysicalweight 41
Theprovisionoffoodanddrinkforchildrenandadults 42
Children’svisitsduringbedtime 43
Providingopportunitiesforprimaryprovisionandmattersrelated
toprivacyandsafety 45
3. Therapeutic Task with Emotionally Integrated Children –
Theory and Practice 48
Workingwithfragilelyintegratedchildren 48
Workingwithemotionallyintegratedandunintegratedchildrentogether 52
Criteriaforassessingwhetherachildisreadytomoveon 54
Becomingemotionallyintegratedandmovingon 56
Themovefromaprimaryhouseandfuturecontactwiththechild 57
Thereferralprocessfromaprimarytosecondaryhouse 58
4. Therapeutic Education 61
Theinterrelationshipofeducationandtherapy 61
Theimportanceofeducationinthetreatmentoftraumatizedchildren 64
Thechild’sexperienceofseparationbetweencareandeducation 66
GCSEsandtherelationshipbetweenachild’sacademic
andemotionaldevelopment 67
Regressionwithintheeducationsetting 69
House–schoolhandovers 70
Theinvolvementofachild’scarerwithhistimeinschool 71
Workingwithbreakdownintheschool 72
Learningsupport 74
Schoolhomework 76
Educationstaff’sinvolvementwithneedsassessments 77
Workingonconflictbetweencareandeducationstaff 78
5. Play 80
Opportunitiesforplayinhouses 80
Playandactivitywithchildren 81
Childrenplayinggamesthathaveanelementofdanger 83
Thesymbolicandreality-baseduseof toysinchildren’splay 84
Theuseofsensoryexperienceroomsforchildrenwithlearning
difficulties 85
6. Therapeutic Communication – Individual and Group 86
Meetings for Children
Theuseofindividualmeetingsinthetreatmentofemotionally
deprivedchildren 86
Therecordingofchildren’sindividualmeetings 94
Theuseofdollsandotherfiguresinchildren’smeetings 94
Talkinggroups 95
Thepotentialuseof housegroupmeetings 96
Howdoadultsworktogetheringroupmeetings? 98
Timeboundariesandworkingthroughdifficulties 100
Workingwithchildrenwhofinditextremelydifficulttobeingroups 102
7. Language 104
Theuseoflanguage 104
Thingswesaytochildrenthatfeelinappropriate 106
Theuseofhumor 107
Theuseofshouting 108
8. Delinquent Excitement and Subculture 110
Delinquencyasasignof hope 111
Workingwithdelinquentexcitementandsubcultureingroups
ofchildren 113
Workingwithexcitementinthegroupaboutdrugs 114
Howdoweworkwithaspectsof youthculturethatmaybeoffensive? 115
Tarotcardsandothertypesof fortune-telling 117
9. Authority, Consequences and Reparation 118
Workingwithconsequences 118
Workingthroughdifficultieswithchildren 121
Authority 123
Authorityandcontainmentintimesof change 125
Theuseoftheword‘boundaries’ 126
10. Gender Issues, Sexuality and Dress 127
Thegenderbalanceinteams 127
Dressandappearanceinwork 128
Dressandsexuality 129
Menwearingearringsatwork 130
Theprovisionofsexeducationforemotionallyunintegratedchildren 131
Children’ssexualityandinvolvementwitheachother 134
11. Working with Absence and Break Periods 137
Goingawayforbreakperiods 138
Workwithchildrenduringbreakperiods 139
Supportforchildrenwhoareawayforbreakperiods 140
Workingwiththeimpactof staffillnessandabsence 141
Staffmeetingsandmattersrelatedtoabsence 143
Staffattendanceonexternalcoursesandtheimplicationsfortreatment 144
Achild’scarerleavinghimsomethingwhenshegoes 145
12. Leavings, Endings and Beginnings 147
Preparationforachild’splannedleaving 147
Markingachild’sleavingfromahouse 148
Specialtripoutprovidedforachildbyanadultwhoisleaving 150
Thecontinuingcontactwithachildafterheleavesahouse 150
Futurecontactwithanadultwhohasleft 151
Workingwithacarer’sleavingandthecareofindividualchildren
duringthischange 152
Thetransitionbetweencarerswhenachild’scarerleaves 154
Theintroductionofanewchildtothehouseandschool 155
Changeofleadershipandpossibleimpact 155
13. External Reality and Protection from Impingement 158
(intolerable disruption and stimulation)
Childrenusingtoysandmagazineswithviolentandoffensiveimages 159
Howdowemanagethingschildrenbringbacktothehouse? 159
Workingwithnewsitemswithchildren 160
ThemassacreatDunblane(1996) 161
Theimpactofexternalprocessesontreatment 162
14. Working with Violence and Aggression 164
Understandingviolenceandaggression 164
Howdowerespondtoparticularlyviolentattacksonstaffbychildren? 166
Howdowetakeviolenceseriously? 167
Howdoweunderstandachildwhoharms,injures
orkillsalivingcreature? 169
Physicalrestraint–whatwelearnfromtraining 170
Genderissuesinrelationtothetherapeuticmanagementofviolence
andphysicalrestraint 172
Physicalrestraintandphysicalholding 173
Bullying 174
15. Working with Strong Feelings and Supervision 175
Thesupervisor’stask 175
Supervisionwithastaffmemberwhohasbeenphysically
attackedbyachild 177
Workwithchildrentowardswhomwehavepowerfulangryfeelings 178
Whatisourapproachtoworkwithachildwhowefeelisstuck? 179
Vulnerabilityinresidentialworkwithchildren 180
16. Management Structure and the Therapeutic Task 182
Management,treatmentandsafety 182
Contactbetweenseniormanagersandhouses 184
Staffhoursofworkinrelationtothetherapeutictask 187
Thereductionofhoursstaffworkanditsimpactonthe
therapeuticapproach 188
Dowehaveenoughunplannedtimeatwork? 191
Preservingthinkingspaceindifficulttimes 192
17. Special Events 195
ThegivingandreceivingofpresentsatChristmas 195
Birthdays 197
Groupholidays 198
18. Other Questions, Other Possibilities 200
Workingwithchildren’sparents 200
Bedwettingandsoiling 202
Children’sclothingandappearance 203
Childrenbuyingtheirownteddybears 205
Ticklingandplayfighting 206
Peergrouprelationshipsforchildren 207
Thepossibleimplicationsoflockablecupboardsorboxesforchildren 209
references 211
subject index 214
author index 223
